Alemayehu Meron Asmamaw, Birhanie Atalay Liknaw, Abebe Moges Tadesse, Tilahun Werkneh Melkie, Asferie Worku Necho, Yalew Anteneh Kassa, Agimas Muluken Chanie, Tesfie Tigabu Kidie, Aweke Mekuriaw Nibret, Aragaw Fantu Mamo
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
Arch Public Health. 2024 Sep 26;82(1):165. doi: 10.1186/s13690-024-01380-8.
One of the reasons for the high rates of maternal and child morbidity and mortality in Sub-Saharan Africa is the rising proportion of teenage pregnancy. Preventing teenage pregnancy is critical to meeting sustainable development goal number three which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. To support the achievement of this goal, this study aimed to assess the spatial variation and factors associated with teenage pregnancy in Ethiopia using the recent nationally representative data.
A secondary data analysis of the 2019 Ethiopian mini Demographic and Health Survey was conducted with a total weighted sample of 2211 (unweighted 2100) teenagers. The Bernoulli model was fitted using SaTScan version 9.6 to identify hotspot areas and the geospatial pattern and prediction of teenage pregnancy were mapped using ArcGIS version 10.7. A multilevel logistic regression model was fitted to identify factors associated with teenage pregnancy among teenagers. Adjusted OR with 95% CI was calculated and variables having a p-value less than 0.05 were statistically significant factors of teenage pregnancy.
The prevalence of teenage pregnancy among adolescents aged 15-19 years in Ethiopia was 12.89% (95% CI: 11.56%, 14.36%). The SaTScan analysis identified a primary cluster in the Gambella region of Ethiopia (log-likelihood ratio = 14.02, p < 0.001). A high prevalence of teenage pregnancy was observed in Somalia, Afar, Gambella, and the southern part of the Oromia regions of Ethiopia. Age, educational status- primary and secondary, religion- protestant, having television, contraceptive knowledge, household head-female, and region- Small peripheral were significant determinants of teenage pregnancy.
The spatial distribution of teenage pregnancy in Ethiopia was nonrandom. Age, educational status, religion, having television, contraceptive knowledge, sex of household head, and region were significant determinants of teenage pregnancy. Therefore, concerned government bodies and other stakeholders should organize periodic educational campaigns and youth-friendly reproductive health services. Collaboration between healthcare professionals, and religious and community leaders could also form a strategic partnership that makes interventions more comprehensive, culturally sensitive, and effective in reducing teenage pregnancy.
撒哈拉以南非洲地区孕产妇和儿童发病率及死亡率居高不下的原因之一是青少年怀孕比例不断上升。预防青少年怀孕对于实现可持续发展目标3至关重要，该目标旨在将全球孕产妇死亡率降至每10万活产少于70例。为支持实现这一目标，本研究旨在利用近期具有全国代表性的数据评估埃塞俄比亚青少年怀孕的空间差异及相关因素。
对2019年埃塞俄比亚小型人口与健康调查进行二次数据分析，总加权样本为2211名（未加权2100名）青少年。使用SaTScan 9.6版本拟合伯努利模型以识别热点地区，并使用ArcGIS 10.7版本绘制青少年怀孕的地理空间模式和预测图。拟合多级逻辑回归模型以识别青少年中与青少年怀孕相关的因素。计算调整后的比值比及95%置信区间，p值小于0.05的变量为青少年怀孕的统计学显著因素。
埃塞俄比亚15至19岁青少年中青少年怀孕的患病率为12.89%（95%置信区间：11.56%，14.36%）。SaTScan分析在埃塞俄比亚的甘贝拉地区识别出一个主要聚集区（对数似然比 = 14.02，p < 0.001）。在埃塞俄比亚的索马里、阿法尔、甘贝拉以及奥罗米亚地区南部观察到青少年怀孕的高患病率。年龄、教育程度（小学和中学）、宗教（新教）、拥有电视、避孕知识、户主性别（女性）以及地区（小型周边地区）是青少年怀孕的显著决定因素。
埃塞俄比亚青少年怀孕的空间分布并非随机。年龄、教育程度、宗教、拥有电视、避孕知识、户主性别和地区是青少年怀孕的显著决定因素。因此，相关政府机构和其他利益攸关方应组织定期教育活动和对青少年友好的生殖健康服务。医疗保健专业人员与宗教及社区领袖之间的合作也可形成战略伙伴关系，使干预措施更全面、对文化敏感且能有效减少青少年怀孕。
